Holiday Tummy Troubles

Every year, many of us take a summer holiday abroad, and inevitably, a large proportion of us are likely to suffer from some kind of stomach upset as a result of changes in diet, over-indulgence or simply a hangover! Here, the Consumer Health Information Centre gives advice on avoiding tummy troubles on holiday.

Holiday Indigestion
Despite our best efforts to watch what we eat when away on holiday, we very often allow ourselves to over-indulge. With all-you-can-eat buffets and tempting foreign cuisines, we can often find ourselves over-eating and ending up with indigestion.

When we eat, our stomach produces acid to break down and digest food. However these juices are usually kept inside the stomach by a muscle at the bottom of the food pipe from the mouth (the oesophagus), which tightens and closes. Occasionally the acid juices can be squeezed up the oesophagus, causing a burning sensation in the chest known as 'heartburn'. Also, although our stomachs need acid to digest food, some people over-produce acid and this can cause stomach ache. Other indigestion problems include feeling full, heavy or bloated: these can happen simply due to the normal action of the stomach slowing down and causing the food to stay in the stomach too long. Finally, trapped gas, due to tiny bubbles of gas collecting in the stomach, although common, can be painful and uncomfortable and cause people distress.

However, there are a wide range of OTC remedies available for indigestion that you can pack in your holiday first-aid kit:

Antacids: If suffering from heartburn or excess acid, antacids will neutralise any excess acid in the stomach giving fast relief

Alginates: These lie on top of the contents of the stomach, stopping acid from rising up into the oesophagus, and relieving heartburn

Acid reducers: These actually stop the stomach from producing too much acid. Furthermore, if you know you are going to eat or drink something that usually gives you heartburn (e.g. spicy food) there are certain types of acid reducers (H2-antagonists) that you can take in advance to prevent expected symptoms. These medicines are long acting (up to 12 hours) so a dose can protect throughout a whole evening.

If you know you suffer from indigestion, or just want to take precautions, ask your pharmacist which remedy would be most suitable for you.

Holiday Diarrhoea

Diarrhoea is generally defined as frequent, loose or liquid stools, and is commonly caused on holiday by bacteria transmitted through food or water. Your risk of suffering from diarrhoea on holiday is very much related to your destination and level of accommodation, however, even the finest food or drink in the finest hotel could upset a particularly sensitive stomach. There are, however, several precautions you can take to minimise your chances of experiencing diarrhoea on holiday.

• Make sure that any meat you eat is well cooked. If you are in a local restaurant ask for it to be cooked a little more as a precaution, even if you like your meat rare
• If you are self-catering, wash salad leaves thoroughly before serving
• Avoid any food that has been re-heated and left at room temperature for long periods (eg. buffets)
• Care with water is essential. Unless you are specifically told that the tap water is safe to drink, you are better advised to drink bottled water, just to be on the safe side
• It is also good practice in developing countries to use sealed, bottled water, for cleaning teeth, washing fruit and making ice if you are self-catering. In fact, when in a bar or restaurant, ask for no ice in your drink as the ice cubes will have been made from tap water.
• Always wash your hands thoroughly after using the bathroom and before consuming food to prevent contamination

Treatment of holiday diarrhoea
Flush it out: The first rule when diarrhoea attacks is to try to get some rest and drink plenty of clear fluids eg. bottled water. Not only will this help flush out the cause of the problem, but will also prevent you from becoming dehydrated, which is particularly important if you are in a hot climate

Watch what else you eat: If you do feel like eating, good foods are bananas, salted crisps, rice or clear soups, and avoid alcohol at all costs as this could irritate your stomach further

In most cases, holiday diarrhoea is self-limiting and with a little rest and rehydration you can be on your way again. However, you may be wise to pack an OTC anti-diarrhoeal medicine in your luggage, just in case.

OTC treatments: Taking an over-the-counter anti-diarrhoeal medication such as Loperamide or co-phenotrope will stop the diarrhoea, especially if you have a flight to catch. These work by slowing down the movements of the gut and restoring natural balance. Therefore you may not need to go to the toilet for a while after taking the medication, but gut movements will return to normal. If you have suffered from bowel problems in the past, or are passing blood, you should discuss an alternative treatment with your doctor before you leave for your trip.

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When should you seek help
If after 24-48 hours the diarrhoea does not improve or worsens, it is wise to seek medical attention, as although most bouts of holiday diarrhoea are not serious, an on-going bout could indicate other conditions.

Holiday Constipation
Holiday diarrhoea is something that many of us are familiar with. However, a change of routine and a lack of fibre, in combination with lack of exercise, can often lead to the opposite problem: constipation. Lazing about in the sun, eating rich foods and drinking alcohol can be par for course when it comes to a yearly break, but it can potentially block up your digestive system.

If you find you are temporarily suffering from constipation, there are remedies you can buy over-the-counter and take with you on holiday. These remedies fall into different categories depending on their mode of action:

Motility enhancers: These stimulate contractions of the muscles in the bowel to reduce the time it takes for waste to travel through the bowel.
Bulk-forming agents: Containing natural fibre, these help add bulk to the stool so they are passed more easily.

Osmotic laxatives: These help draw water into the bowel helping to moisten the stool, making it easier to pass.

Lubricating agents/faecal softeners: These lubricate hard stools, making them easier to pass.

Hangovers
Finally, remember alcohol dehydrates you, so make sure you drink enough water. If you are suffering the consequences of too much food and drink, there are a number of remedies at hand to help you through your recovery.

Treat your hangover with a pain relief product such as paracetamol and drink plenty fluids to ensure you re-hydrate yourself.